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We are presently studying the effects of antidepressant pharmacological treatment of somatoform conditions and functional syndromes through a critical survey of the literature on randomised controlled trials of this non-homogeneous group of patients. We are searching systematically in the following databases: MEDLINE, EMBASE, PsycLit, the Cochrane Library and the Science Citation Index. We are also searching manually by going through references from relevant reviews and meta-analyses of adult patients with medically inexplicable symptoms and symptom syndromes who have been tested for the effects of treatment with at least one antidepressant drug in a RCT up to August 2002. The trials have been characterized by very different inclusion criteria and diagnostic categories, as well as by the use of innumerable measures of effect. There is a lack of information about the degree of the effects. Furthermore, there is often a lack of information about design and compliance. It is not possible to draw definite conclusions based on the findings, but there seems to be ground for the assumption that antidepressants have an effect on patients' functional condition. Based on these findings, we find that there is a need for more transparent (cf. CONSORT statement), larger, well-designed, double-blind, parallel-group, placebo-controlled trials of sufficient duration and adequately high, serum-monitored doses in a comprehensively recruited group which is well-defined through diagnostic interviews and assessment, in order to reduce selection bias.

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